Colon Rectal Surgeons Inc.

Frequently Asked Billing Questions

How do I know what I will owe for my procedure?

Every insurance company is different, so we recommend you contact your insurance company and verify your benefits for the procedure. Some insurance companies require preoperative CPT and Diagnosis codes. Please contact the billing department at 402.343.1122 if you require this information.

Here is a list of questions to ask your insurance carrier:

  1. What are my plan benefits for a screening colonoscopy? Diagnostic colonoscopy?
  2. What is my deductible? How much of the deductible have I met?
  3. What is my maximum co-insurance responsibility? How much of this have I met?
  4. If the physician removes a polyp or finds any other issues, will this change my out of pocket responsibility?
  5. Is the facility I am having my procedure at in-network?
  6. Are there age and or frequency limits for my colonoscopy?

Remember, it is very important to record the name of the representative you spoke with, the date and time of the call, and a reference number for the discussion.

 

I’m having a procedure, who should I expect statements from?

Patients who have procedures in The Colonoscopy Center Inc will receive statements from separate entities, including Colon and Rectal Surgery Inc and The Colonoscopy Center.

  • The statement from The Colonoscopy Center is the facility charges, similar to a statement you would receive if your procedure was performed in a hospital setting. The statement is red in color.
  • The statement from Colon and Rectal Surgery Inc is the physician charges for the procedure. The statement is blue in color.

Additionally, you may receive statements from anesthesia, pathology, and laboratory.

 

I came in for a Screening Colonoscopy, but they found a something. What now?

The benefits will depend on your insurance policy. Certain plans will consider the first service preventative even if the colonoscopy detects cancer, polyps, or lesions. It is important to note that after the first procedure, future procedures will be considered diagnostic. We recommend you contact your insurance company for information specific to your insurance plan. You may also check out our billing information page for more details.

 

My insurance company says that if my procedure was coded as a screening, they would cover it. Can the physician change, add, or delete the codes so it is considered screening?

No. Claims are coded according to the medical record from information you have provided, as well as evaluation from the physician. These are legally binding documents that cannot be changed to facilitate better insurance benefits.